10 Years On: Just How Close Are We To Closing The Gap?

AVALON, AUSTRALIA - JANUARY 26: The Australian and Aboriginal flags displayed on January 26, 2016 in Avalon, Australia. Australia Day, formerly known as Foundation Day, is the official national day of Australia and is celebrated annually on January 26 to commemorate the arrival of the First Fleet to Sydney in 1788. (Photo by Ashley Feder/Getty Images)

It's been 10 years since the Close the Gap campaign launched. The goal was to eliminate the health and life expectancy gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians by 2030.

The campaign was built on evidence that significant improvements in the health status of Aboriginal and Torres Strait Islander peoples could be achieved within short time frames.

Yet while there have been positive developments in particular areas, this anniversary is not a time for rest according to Justin McCaul, Oxfam Australia’s Aboriginal and Torres Strait Islander Peoples Program Manager.

“We are seeing some improvement in particular areas -- child mortality rates are closing -- but overall the picture is marginal improvement across the board and that means we have a long way to go," he told The Huffington Post Australia.

“It’s obvious to see that closing the gap is a priority for the government. What I think we struggle with is the transition of the verbal commitment into maintaining or investing more in the Aboriginal health sector.”

In the ten years since the launch of the campaign, there has been a significant decline in child mortality rates.

Prime Minister Malcolm Turnbull handed down the annual Closing the Gap Report in February, acknowledging that progress had not been made in critical areas, such as Indigenous life expectancy.

“There have been gains in year 12 attainment rates, and a significant decline in child mortality rates,” Turnbull said.

“However, there is slow progress in other critical areas, such as employment and life expectancy.”

Currently, the average life expectancy of Indigenous Australians is still around 10 years less than non-Indigenous Australians, and in some areas there is a difference of 20 years, according to Dr Brian Owler, President of the Australian Medical Association.

“Aboriginal and Torres Strait Islander people continue to experience stubbornly high levels of treatable and preventable conditions, such as type 2 diabetes, rheumatic heart disease, kidney disease, and other life-shortening conditions,” Owler said.

There’s no denying that the Close the Gap Campaign has received a surge of support from the Australian public since its launch.

“This generation of Australians is demanding decisive action from government[s] to close the unacceptable gap in life expectancy between our First Peoples and the non-Indigenous population.

“In 2016, it is simply unacceptable that Aboriginal and Torres Strait Islander people have a life expectancy at least 10 years shorter than non-Indigenous Australians.”

What is being done to close the gap?

A major breakthrough for the campaign was seen in 2008 when all sides of politics collectively pledged their support in signing the ‘Close the Gap Statement of Intent’ -- followed by funding of $1.6 billion, committed over four years.

From 2009 onwards, improvements were observed in infant and child health outcomes, a gradual closing of the gap in smoking rates, significant increases to the number of health checks and increased access to medicines due to higher levels of resourcing to the Indigenous health sector.

In some areas, the average life expectancy of Indigenous Australians is 20 years less than non-Indigenous Australians.

Oxfam Australia’s McCaul said the Aboriginal Community Controlled Health service has played a significant role in addressing the disparity in health equality.

It's a primary health care service initiated and operated by the local Aboriginal community to deliver culturally appropriate health care, operating in over 150 locations throughout urban, regional and remote Australia.

“I’ve had conversations with a number of state and national level Aboriginal health organisations,” McCaul said.

“It may be anecdotal, but their take on this situation is Aboriginal people are much more likely to seek medical advice from an Aboriginal or Torres Strait Islander managed health service.

“For Aboriginal people, it’s about accessing services that are culturally appropriate so they know they are going to be managed and dealt with in a way that isn’t going to be alienating.

“The simple thing of just accessing health services has been identified as an improvement in the campaign so far.”

In addition to this, the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 has also been implemented, identifying areas of focus to guide future investment and effort in relation to improving the health of Indigenous Australians.

As well as its commitment to improving health outcomes, the government has also set employment and education goals with improvements to Year 12 attainment rates.

“There’s a real connection between something like closing the gap on health and equality, investing in Aboriginal controlled health organisations and investing in the education and training of Aboriginal health workers too,” McCaul said.

A Case Study: Aboriginal People Are More Likely To Die From Bowel Cancer After Surgery Than Non-Aboriginal People

Research released from Cancer Council NSW on Thursday found that Aboriginal people who received surgical treatment were 68 percent more likely to die from bowel cancer five years after diagnosis than non-Aboriginal people.

Cancer Council NSW senior researcher Dianne O’Connell said the findings may be explained by a variety of reasons including a potential lack of long-term follow up tests undertaken by Aboriginal people, reduced access to health services, poor support mechanisms, cultural and practical barriers within the health system and health literacy.

“We know that there are significant cultural barriers for Aboriginal people accessing health services,” she said.

“These barriers mean that Aboriginal people may be reluctant to access a cancer service and complete their treatment due to a lack of cultural safety, inadequate support and an unwelcoming environment.

“Increasing the number of Aboriginal people working in cancer services is an important part of breaking down these cultural barriers and helping to close the gap.”

President of the Australian Medical Students Association, Elise Buisson, told HuffPost Australia that a higher number of Indigenous medical professionals would aid in closing the gap.

McCaul agreed, saying since the Close the Gap campaign was launched there had been an observed increase in the amount of indigenous Australians accessing health services.

“We are seeing Aboriginal and Torres Strait Islander people using health services more and more,” he said.

“That’s absolutely a positive thing and will contribute towards people being diagnosed and treated before their health gets to a point where they are unable to recover.”

Where to from here?

According to the 2016 Progress and Priorities Report from the Australian Human Rights Commission, improvements to Aboriginal and Torres Strait Islander life expectancy should not be expected to be measurable until at least 2018.

“Once you’re immersed in the Aboriginal health sector and you see what they do, you do get quite hopeful and feel very positive about the work that is being done and just how close we can get to closing the gap,” McCaul said.

“It comes back to the issue of maintaining momentum by providing funding to Aboriginal controlled health organisations.”

With the 2016-17 Federal Budget expected to be delivered in the coming weeks, all eyes will be on Prime Minister Malcolm Turnbull and Treasurer Scott Morrison.

All eyes will be on Treasurer Scott Morrison when the Federal Budget is delivered.

“The budget is one of the key markers for the Close the Gap campaign in seeing the Government’s financial commitment towards health,” McCaul said.

He urged the Government to follow through on its commitments to ensure the health targets are met.

Speaking at the Redfern Community Centre on Thursday, Gooda urged the Government not to cut funding towards the campaign.

“We know Australia’s going through a hard time with budgetary matters but I will say this to [the] Government - you can’t cut your way towards Closing the Gap,” Gooda said.

“If you think you are going to cut resources and maintain the commitment to meet this Closing the Gap target by 2030, we’re all kidding ourselves.”

For Professor Tom Calma -- the former Aboriginal and Torres Strait Islander Commissioner whose 2005 Social Justice Report provided the catalyst for the Close the Gap Campaign -- it is important bipartisan support is maintained.

“We’ve got to try and make sure that all portfolios of Government work together and we have to make sure that Indigenous affairs doesn’t become the political football it does too often between governments and oppositions,” he said on ABC News on Thursday.

“We need to embrace the approach that we actually signed off in 2008 on a statement of intent with the Government and the Opposition to say they would work together.

“We are not asking for billions more dollars; we are asking for better performance on behalf of governments and [the] key to it all is working with Aboriginal [and] Torres Strait Islander people and our community-controlled health organisations in a very clear and strategic way.”